CDC warns of infection risks from contaminated tattoo inkThe US Centers for Disease Control and Prevention (CDC) and its state partners today reported on a rash of recent nontuberculous mycobacterial (NTM) skin infections linked to tattoo ink contaminated during production or when diluted at parlors. They described 22 infections reported in 2011 and 2012 from four states: New York, Washington, Iowa, and Colorado. Tattoo-related NTM infectious are infrequently reported and can range from mild inflammation with rash or papules to severe abscesses that require extensive surgical debridement. The recent clusters came to the CDC's attention when New York officials reported Mycobacterium chelonae skin infections in 14 residents who received tattoos in the last 4 months of 2011. All were linked to prediluted gray ink made by the same company. A CDC alert to identify similar cases in other states turned up similar infections with other types of ink in the other three states. Testing
found NTM contamination in tattoo inks used in 2 of 5 case clusters. A cluster in Washington involved a different strain, M abscessus. Inspections at two manufacturing facilities did not find the organism, but investigators wrote that in some instances, a tattoo artist rinsed needles with distilled or reverse osmosis water, which isn't sterile and could contain the organisms. The authors wrote that the report illustrates the risk of tattoo-linked NTM skin infections and the need for tattoo artists to use sterile ink products, sterile water when ink dilution is needed, and hygienic practices when tattooing.Aug 22 MMWRreport

Slaughterhouse cruelty video prompts USDA food safety probeThe US Department of Agriculture (USDA) said yesterday that it is investigating evidence of disturbing and inhumane treatment of cattle, along with possible food safety violations, at a California facility, based on video it received from the animal welfare organization Compassion Over Killing (COK). The USDA said in a statement that its Food Safety and Inspection Service (FSIS) is pulling inspectors from Central Valley Meat, based in Hanford, Calif., an action that halts slaughter operations. FSIS investigators immediately launched in investigation, which found violations in humane handling. The agency said the video footage does not show "downer" animals entering the food supply but said the FSIS is conducting a thorough investigation on the food safety aspects of how the animals were handled. USDA regulations state that if animals are nonambulatory any time before slaughter, they must be promptly condemned, humanely
euthanized, and properly discarded so the animal materials do not enter the food supply. USDA rules that bar downer cattle from entering the food supply are one of its defenses against bovine spongiform encephalopathy (BSE). In 2008, a Humane Society of the United States video of another California slaughterhouse that showed workers moving disabled dairy cows led to the recall of 143 million pound of beef, the largest recall in US history. COK said in a press release yesterday that Central Valley Meat is a major supplier to the USDA's school lunch program and other federal food programs.Aug 21 USDA press releaseAug 21 COK press release

New tool screens antimalarials for resistanceResearchers at the Medicines for Malaria Venture (MMV), a public-private nonprofit group in Geneva, today released a framework that it will use to assess malaria drugs in development for the risk of resistance. The group published its findings in an early online edition of Malaria Journal. The system is a test cascade of six steps based on three experimental procedures that allows investigators to classify the compound resistance risk profiles as low, elevated, or major, according the report. The major rating signifies that the compound faces preexisting resistance or is likely to select new clinically significant resistance mechanisms, and in the absence of mitigating factors the major classification would bar further development. Tim Wells, MMV's chief scientific officer, said in a press release that profiling MMV's drug development portfolio as early as possible will help ensure that none will face resistance. "This will also
help us cost-effectively accelerate the drug development process and be prepared in advance with a full resistance profile, which is required by regulatory authorities before a new drug can be approved, he added. Resistance to antimalaria drugs is a major concern among global health officials in light of reports from Cambodia of resistance to artemisinin, a key component in the battle against malaria.Aug 22 Malaria JournalabstractAug 22 EurekAlert press release

Sharp uptick in cholera in Sierra LeoneSierra Leone, which has been monitoring a cholera outbreak all year, is seeing a much-accelerated rate of infection during August. The total cases for the year number 11,653 with 216 deaths, according to a World Health Organization (WHO) alert today, and the total for August alone is 5,706. Of the country's 13 districts, 10 have recorded cases, with two new districts—Bonthe and Kono—recently added to the list and Western Area and Tonkolili most heavily affected. The president of the African country has declared the situation a humanitarian crisis, and the Ministry of Health and Sanitation, in partnership with Doctors Without Borders (MSF), the World Health Organization (WHO), and other organizations, has implemented prevention and control measures. WHO has also deployed epidemiologists and cholera experts to the country. The region's last cholera epidemic was in 2007, says an MSF article, and many people in the area have gradually lost their
immunity. Cholera, which is often fatal, is spread through contaminated water and food and flourishes in areas with unsanitary conditions. West Africa is entering its rainy season.Aug 22 WHO alertAug 21 UN News Centre storyAug 20 MSF story

New tool for measuring public health impact of disastersA proposed measurement tool for the public health arsenal could aid in objectively and accurately identifying the scope and scale of critical needs and the relief priorities for populations experiencing complex humanitarian emergencies (CHEs), say the authors of a study published yesterday in PLoS Currents: Disasters. Organizations and agencies responding to disasters use a variety of different assessment scales; the researchers' objective was to conceptualize a tool that would provide objective, quantitative, and cumulative measures of public health parameters in emergency situations. The tool, named the Public Health Impact Severity Scale (PHISS), comprises 12 parameters—such as excess mortality, number of children with malnutrition, and number of displaced persons—that fall within the four categories spelled out in the Minimum Standards for Disaster Response developed by the Sphere Project: health, shelter, food and
nutrition, and water and sanitation. PHISS scores can range from zero to 100. The authors acknowledge that further study is needed to test the tool's validity, feasibility, and reliability.Aug 21 PLoS Currents studyDescription of Sphere Project